Individual
JERROD BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2461 5TH ST N, COLUMBUS, MS 39705-2005
(662) 327-0079
Mailing address
231 SUMMER OAKS DR, LAMAR, MS 38642-9132
(662) 769-1319
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-100258
MS
Other
Enumeration date
09/22/2021
Last updated
09/22/2021
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